磁共振成像技术对胰腺导管内乳头状黏液瘤的诊断价值

Diagnostic value of magnetic resonance imaging for intraductal papillary mucinous tumor of pancreas

目的探讨磁共振成像技术对胰腺导管内乳头状黏液瘤(ZPMN)的诊断价值。方法研究选择的对象共24例,均为我院2005年1月～2013年1月间收治的IPMN患者,均采用磁共振成像技术诊断,回顾分析其临床资料。结果检查显示主胰管型共6例,其中弥漫型4例,位于胰头部的节段型2例,MRI检查以主胰管弥漫性扩张或节段性扩张为主要表现,呈长T1低信号,同时呈长T2高信号;主胰管在MRCP图像上显示扩张呈中-重度,管径>9 mm。弥漫型病例均有胰腺实质萎缩伴发。分支胰管型18例,共中钩突部和胰头14例,胰体部4例;多房型16例,单房型2例。MRI检查显示为多个或单个囊性病变簇状组成,为长T1低信号、长T2高信号,其间有短T2低信号分隔影存在,为线条状,MRCP检查显示主胰管同上述囊性肿瘤相通,其中主胰管伴轻、重度扩张8例。分支胰管型所占比例显著高于主胰管型,差异有统计学意义(P<0.05)。结论胰腺导管内乳头状黏液瘤诊断中,MRI具有较高有效性,并具无创特点,使诊断准确率明显提高,具有非常积极的临床意义。

Objective To study the diagnostic value of magnetic resonance imaging for intraductal papillary mucinoustumor of pancreas （IPMN）. Methods Retrospectively analyzed the clinical data of 24 patients with IPMN, who were di-agnosed by magnetic resonance imaging and admitted in our hospital from January 2005 to January 2013. Results Thestudy demonstrated that there were 6 cases of main duct type, included 4 cases of diffuse type and 2 cases of segmen-tal type located in the pancreatic head, MRI showed that the major performance were diffuse expansion of main pan-creatic duct or segmental expansion, presented long T1 low-signal,and long T2 high-signals; the main pancreatic ductdemonstrated medium or severe expansion in MRCP image, pipe diameter 〉9 mm. All the diffuse type cases werecomplicated with the atrophy of pancreatic parenchyma. 18 cases were branch duct type, included 14 cases of uncinateprocess and head of pancreas, 4 cases of pancreatic body; 16 cases of multilocular type and 2 cases of unilocular type.MRI showed multiple or single cystic lesion of clusters, presented long T1 low-signal, and long T2 high-signals, exist-ed short T2 low-signal separation as line shape, MRCP demonstrated that the main pancreatic duct communicate withcystic tumor,and 8 cases of main pancreatic duct complicated with medium or severe expansion. The proportion ofbranch duct type were significantly higher than main pancreatic duct type, and the difference was statistically signifi-cant （P 〈 0.05）. Conclusion MRI is effective in the diagnosis of intraductal papillary mucinous tumor of pancreas, andit has the characteristic of noninvasive, improves the diagnostic accuracy significantly, and has very positive clinicalsignificance.